We elucidate here the process-structure-property relationships in three-dimensional (3D) implantable titanium alloy biomaterials processed by electron beam melting (EBM) that is based on the principle of additive manufacturing. The conventional methods for processing of biomedical devices including freeze casting and sintering are limited because of the difficulties in adaptation at the host site and difference in the micro/macrostructure, mechanical, and physical properties with the host tissue. In this regard, EBM has a unique advantage of processing patient-specific complex designs, which can be either obtained from the computed tomography (CT) scan of the defect site or through a computeraided design (CAD) program. This review introduces and summarizes the evolution and underlying reasons that have motivated 3D printing of scaffolds for tissue regeneration. The overview comprises of two parts for obtaining ultimate functionalities. The first part focuses on obtaining the ultimate functionalities in terms of mechanical properties of 3D titanium alloy scaffolds fabricated by EBM with different characteristics based on design, unit cell, processing parameters, scan speed, porosity, and heat treatment. The second part focuses on the advancement of enhancing biological responses of these 3D scaffolds and the influence of surface modification on cell-material interactions. The overview concludes with a discussion on the clinical trials of these 3D porous scaffolds illustrating their potential in meeting the current needs of the biomedical industry.